腎機能の生理学的発達を考慮した腎排泄型薬剤における新生児・乳幼児薬用量の推定

• 鈴木 信也

  昭和大学薬学部 神奈川県警友会けいゆう病院薬局

• 村山 悠佳

  昭和大学薬学部

• 杉山 恵理花

  昭和大学薬学部

• 関山 正夫

  神奈川県警友会けいゆう病院薬局

• 佐藤 均

  昭和大学薬学部

書誌事項

タイトル別名

• Dose Estimation for Renal-excretion Drugs in Neonates and Infants Based on Physiological Development of Renal Function
• ジンキノウ ノ セイリガクテキ ハッタツ オ コウリョ シタ ジンハイセツガタ ヤクザイ ニ オケル シンセイジ ニュウヨウジ ヤクヨウリョウ ノ スイテイ

抄録

  We established dose estimation formulae for renal-excretion drugs using the glomerular filtration rate (GFR), tubular secretion clearance (Sc), and unbound fraction of drug in plasma (fp) as a renal function index of physiological development in neonates and infants not more than 2 years of age. A dose ratio of (D_C/D_A)=clearance ratio of (CL_C/CL_A)≅(fp_C·GFR_C)/(fp_A·GFR_A) for neonates and infants/adults was applied to drugs with fp·GFR>Sc, while D_C/D_A=CL_C/CL_A≅(β·BSA_C+fp_C·GFR_C)/(β·BSA_A+fp_A·GFR_A) was applied to drugs with Sc>fp·GFR using the coefficient of each drug (β) and body surface area (BSA). Validity of the estimation formulae was investigated in drugs with fp·GFR>Sc such as vancomycin (VCM), arbekacin (ABK), fosfomycin (FOM) and norfloxacin (NFLX), and in drugs with Sc>fp·GFR such as digoxin (DGX) and amoxicillin (AMPC). First, we compared the clearance ratio (CL_C/ CL_A) of VCM, ABK, and DGX estimated by our method with those calculated using the Japanese population clear- ance values and those estimated allometrically (BSA_C/BSA_A). Next, we compared the established doses of all drugs investigated with the doses for neonates and infants calculated from the conventional dose estimation methods for children and our estimation formulae, and evaluated our method. As a result, favorable consistency was observed in the CL ratio for all drugs, and the doses of VCM, FOM, NFLX and AMPC calculated from our estimation formulae approximated the established doses. In conclusion, the validity of the dose estimation method using pharmacokinetic factors related to physiological development (i.e., GFR, fp, Sc) for renal-excretion drugs in neonates and infants was demonstrated.<br>

収録刊行物

• 薬学雑誌

  薬学雑誌 129 (7), 829-842, 2009-07-01

  公益社団法人 日本薬学会

キーワード

• dose estimation
• glomerular filtration rate
• tubular secretion clearance
• unbound fraction of drug in plasma
• neonate
• infant

詳細情報

• CRID: 1390282681105768320
• NII論文ID: 130000135977
• NII書誌ID: AN00284903
• DOI: 10.1248/yakushi.129.829
• ISSN: 13475231
• ISSN: 00316903
• NDL書誌ID: 10328796
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I10328796
• Web Site: https://www.jstage.jst.go.jp/article/yakushi/129/7/129_7_829/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2009328347
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可